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Updated: Jun 3, 2026

Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
Left ventricular diastolic dysfunction in preterm infants with bronchopulmonary dysplasia
Nilkant Phad1,2, Ryan Woodford3, Koert de Waal4,3
1John Hunter Children's Hospital, Newcastle, NSW, Australia. nilkant.phad2@health.nsw.gov.au.
Insights
Infants with bronchopulmonary dysplasia (BPD) show higher rates of pulmonary hypertension (PH) and left ventricular diastolic dysfunction (LVDD). Echocardiography can screen for these conditions in infants with BPD.
Area of Science:
- Neonatal cardiology
- Pediatric pulmonology
- Cardiovascular imaging
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease in preterm infants.
- Left ventricular diastolic dysfunction (LVDD) can occur in infants with BPD.
- Early identification of LVDD is crucial for management.
Purpose of the Study:
- To screen infants with BPD at 36 weeks postmenstrual age for LVDD.
- To evaluate the utility of echocardiographic algorithms for diagnosing LVDD and PH in BPD.
Main Methods:
- Utilized conventional Doppler and myocardial deformation parameters based on the American Society of Echocardiography algorithm.
- Assessed left ventricular (LV) function and diagnosed pulmonary hypertension (PH) using specific parameters.
- Applied age-appropriate cut-off values to identify and grade LVDD.
Main Results:
- Analyzed scans from 71 control infants and 93 infants with BPD.
- Pulmonary hypertension (PH) was detected in 15% of BPD infants versus 7% of controls.
- Grade 2 LVDD was observed in 5% of BPD infants compared to 1.4% of controls.
Conclusions:
- Infants with moderate to severe BPD exhibit a significantly higher incidence of PH and grade 2 LVDD.
- Echocardiographic assessment aids in early detection of diastolic dysfunction in BPD.
- Findings highlight the importance of cardiac screening in infants with BPD.
Introduction:
Echocardiographic algorithm based assessment of diastolic function during neonatal period could help in early identification of left ventricular diastolic dysfunction (LVDD) in infants with bronchopulmonary dysplasia (BPD).
Aim:
To screen infants with BPD at 36 weeks postmenstrual age for LVDD.
Methods:
We used conventional Doppler and myocardial deformation parameters suggested in the latest American Society of Echocardiography algorithm to evaluate LV function. Tricuspid-regurgitation velocity, LV shape, LV eccentricity and pulmonary ejection pattern were used to diagnose pulmonary hypertension (PH). The algorithm was then followed using age appropriate cut-off values to identify and grade LVDD.
Results:
Scans of 71 control infants and 93 infants with BPD were analysed. We noted PH in 15% infants with BPD and 7% control infants. Grade 2 LVDD was seen in 5% infants with BPD compared to 1.4% control infants.
Conclusion:
Rate of PH and grade 2 LVDD was significantly higher in infants with moderate to severe BPD.
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